Guidelines Needed to Help Care for Children During Emergencies
Children Under Age 5 Most at Risk
Evidence-based guidelines for the care of children in emergency situations should be developed and distributed to international relief organizations, according to researchers from the Johns Hopkins Bloomberg School of Public Health and the World Health Organization (WHO). In a review of published literature, the researchers found that the highest mortality rates following armed conflicts, natural disasters, population displacements or famines are often in children younger than five years. The most common causes of death are diarrhea, acute respiratory infections, measles, malaria and malnutrition; these are also the major causes of death in countries with high child mortality rates. The study is published in the January 2006 issue of the Bulletin of the World Health Organization.
“The major causes of child mortality in complex emergencies are well known and we have learned how to manage these conditions in stable situations. However, conflict or disaster often exacerbates the magnitude and severity of these illnesses, requiring rapid assessment and treatment of large numbers of severely ill children. This was seen with the tsunami disaster and the recent earthquake in Pakistan. What we need are simple, easy-to-use guidelines that are brought together in a single package for the different levels of health workers caring for children in complex emergencies,” said William J. Moss, MD, MPH, senior author of the study and an assistant professor in the Bloomberg School of Public Health’s Department of Epidemiology.
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Oral contraceptive pill may prevent more than pregnancy
New research indicates birth control pill could cause long-term problems with testosterone
In the January issue of The Journal of Sexual Medicine, researchers have published a new investigation measuring sex hormone binding globulin (SHBG) before and after discontinuation of the oral contraceptive pill. The research concluded that women who used the oral contraceptive pill may be exposed to long-term problems from low values of "unbound" testosterone potentially leading to continuing sexual, metabolic, and mental health consequences.
Sex hormone binding globulin (SHBG) is the protein that binds testosterone, rendering it unavailable for a woman's physiologic needs. The study showed that in women with sexual dysfunction, elevated SHBG in "Oral Contraceptive Discontinued-Users" did not decrease to values consistent with those of "Never-Users of Oral Contraceptive". Thus, as a consequence of the chronic elevation in sex hormone binding globulin levels, pill users may be at risk for long-standing health problems, including sexual dysfunction.
Oral contraceptives have been the preferred method of birth control because of their ease of use and high rate of effectiveness. However, in some women oral contraceptives have ironically been associated with women's sexual health problems and testosterone hormonal problems. Now there are data that oral contraceptive pills may have lasting adverse effects on the hormone testosterone.
The research, in an article entitled: "Impact of Oral Contraceptives on Sex Hormone Binding Globulin and Androgen Levels: A Retrospective Study in Women with Sexual Dysfunction" published in The Journal of Sexual Medicine, involved 124 premenopausal women with sexual health complaints for more than 6 months. Three groups of women were defined: i) 62 "Oral Contraceptive Continued-Users" had been on oral contraceptives for more than 6 months and continued taking them, ii) 39 "Oral Contraceptive Discontinued-Users" had been on oral contraceptives for more than 6 months and discontinued them, and iii) 23 "Never-Users of Oral Contraceptives" had never taken oral contraceptives. SHBG values were compared at baseline (groups i, ii and iii), while on the oral contraceptive (groups i and ii), and well beyond the 7 day half-life of sex hormone binding globulin at 49-120 (mean 80) days and more than 120 (mean 196) days after discontinuation of oral contraceptives (group ii).
The researchers concluded that SHBG values in the "Oral Contraceptive Continued-Users" were 4 times higher than those in the "Never-Users of Oral Contraceptives". Despite a decrease in SHBG values after discontinuation of oral contraceptive pill use, SHBG levels in "Oral Contraceptive Discontinued-Users" remained elevated when compared to "Never-Users of Oral Contraceptives". This led to the question of whether prolonged exposure to the synthetic estrogens of oral contraceptives induces gene imprinting and increased gene expression of SHBG in the liver in some women who have used the oral contraceptives.
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